影响椎动脉型颈椎病椎—基底动脉Vm的相关因素分析

发布时间：2018-02-28 03:49

本文关键词： 椎动脉型颈椎病椎-基底动脉经颅内多普勒数字化摄影　出处：《黑龙江中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：椎动脉型颈椎病是当代骨科的常见病和多发病,根据国内外专家学者报道,椎动脉型颈椎病仅次于神经根型颈椎病,其发病年龄也高于其它颈椎病[1]。其发病特点主要与头部旋转有关的眩晕,伴有眩晕、事物模糊、耳鸣等症状,严重的病人甚至猝然晕倒、不醒人事,危及健康及生命。目的:通过经颅彩色多普勒超声(TCD)与数字化X射线摄影系统(DR)对椎动脉型颈椎病患者的观察,探析CSA影响椎-基底动脉平均血流速度(Vm)的因素。方法:本研究选择病例均来自2016年01月—2017年01月黑龙江中医药大学附属第一医院骨伤二科门诊符合上述诊断标准患者100例,行TCD及DR检查。观察双侧椎-基底动脉的平均血流速度(Vm)与颈椎的位移程度,椎间隙狭窄,钩椎关节间隙狭窄,颈椎结构变化(曲线变直、成角、后凸、滑脱),椎间孔缩小的关系。结果:通过100例椎动脉型颈椎病的患者的实验分析,应用经颅内多普勒(TCD)和数字化摄影(DR)的检查最终发现,椎间隙狭窄、椎间孔缩小、钩椎关节间隙的狭窄、生理曲度以及颈椎的位移程度这几种因素的改变都具有相关性,并且得出颈椎的位移程度与椎动脉型颈椎病椎-基底动脉的血流速度之间存在明显的统计学差异,结论:1.本研究发现,椎动脉型颈椎病的患者普遍存在颈椎位移失稳的异常变化,其变化形式也比较复杂呈阶段性,提示临床医生在治疗椎动脉型颈椎病患者时应多考虑维持颈椎的稳定性,让患者佩戴围领。2.从数据分析,颈椎的位移程度与椎动脉型颈椎病椎-基底动脉的血流速度之间相关性最强。3.本研究的结果对临床工作有良好的指导意义,经颅内多普勒(TCD)和数字化摄影(DR),是临床诊断的重要客观指标,具有较高的诊断价值。
[Abstract]:Vertebral artery type cervical spondylosis is a common and frequent disease in contemporary orthopaedics. According to the reports of experts and scholars at home and abroad, vertebral artery type cervical spondylosis is second only to nerve root type cervical spondylosis. Its onset age is also higher than that of other cervical spondylosis [1]. The main characteristics of the disease are vertigo associated with head rotation, accompanied by vertigo, blurred things, tinnitus and other symptoms, severe patients even suddenly fainted, unconscious, Objective: to observe the patients with cervical spondylosis of vertebral artery type by transcranial color Doppler ultrasound (TCD) and digital X-ray imaging system (DRR). Methods: from January 2016 to January 2017, all the patients were selected from the second department of bone injury of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine to meet the above diagnostic criteria. TCD and Dr were performed. The mean blood flow velocity (Vm) of bilateral vertebrobasilar artery and the degree of cervical vertebrae displacement, intervertebral space stenosis, hook joint space stenosis, cervical spine structure changes (curve straightening, angulation, kyphosis) were observed. Results: through the experimental analysis of 100 patients with cervical spondylosis of vertebral artery type, we found that the intervertebral space was narrow and the intervertebral foramina was narrowed by using TCD and DRD. The changes in the stenosis of the articular space, the degree of physiological curvature and the degree of displacement of the cervical vertebrae are all related to each other. It is concluded that there is a significant statistical difference between the displacement of cervical vertebrae and the blood flow velocity of vertebrobasilar artery in vertebral artery type cervical spondylosis. The patients with cervical spondylosis of vertebral artery type generally have abnormal changes of displacement instability of cervical vertebrae, and the change forms are complex and phased, which suggests that the clinicians should consider maintaining the stability of cervical vertebrae when treating patients with cervical spondylosis of vertebral artery type. From the data analysis, the degree of cervical vertebrae displacement and the blood flow velocity of vertebrobasilar artery in patients with cervical spondylosis of vertebral artery type were the strongest. 3. The results of this study have good guiding significance for clinical work. Transintracranial Doppler imaging (TCD) and digital digital imaging (DRV) are important objective indexes in clinical diagnosis and have high diagnostic value.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R681.55

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